title: Fatal 2009 pandemic influenza A (H1N1) in a bone marrow transplant recipient.
abstract: Conditions characterized by immunosuppression have been recently reported as risk factors for severe novel swine-origin influenza A (H1N1) virus (S-OIV) infection during the current 2009 pandemic.  We report clinical and virological findings, antiviral therapy, and post-mortem study of S-OIV in an adult bone marrow transplant recipient. The viral genome was amplified by real time reverse transcriptase polymerase chain reaction (RT-PCR) from a nasopharyngeal swab specimen. The patient developed acute respiratory distress syndrome, septic shock, and eventually succumbed with a severe pulmonary haemorrhage. To the best of our knowledge, the entire clinical/therapy management and pathological examination in a transplant recipient infected with the S-OIV has not been previously documented. The fatal ending in this bone marrow transplant recipient supports recommendations that call for education measures, S-OIV vaccination, early diagnosis and aggressive treatment in the transplant population.
authors.affiliation: Intensive Care Unit, Center for Medical and Surgical Research, CIMEQ, Havana, Cuba. aaabdo@infomed.sld.cu
authors.forename: Anselmo
authors.initials: A
authors.lastname: Abdo
authors.forename: Carlos
authors.initials: C
authors.lastname: Alfonso
authors.forename: Guillermo
authors.initials: G
authors.lastname: Diaz
authors.forename: Mario
authors.initials: M
authors.lastname: Wilford
authors.forename: Maykel
authors.initials: M
authors.lastname: Rocha
authors.forename: Niurka
authors.initials: N
authors.lastname: Verdecia
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D017809:Fatal Outcome; D006801:Humans; D007165:Immunosuppression Therapy; D053118:Influenza A Virus, H1N1 Subtype / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification; D007251:Influenza, Human / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology / Q000821:virology*; D008297:Male; D008875:Middle Aged; D053139:Oseltamivir / Q000627:therapeutic use; D020133:Reverse Transcriptase Polymerase Chain Reaction
chemical_list: D000998:Antiviral Agents; D053139:Oseltamivir